| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $229.94 | $5,982.00 | $10,692.00 | |
Aetna
| Facility | 50 | $2,513.32 | $3,881.00 | $8,032.28 |
Horizon BCBS
| Facility | $14,030.14 | $14,030.14 | $16,829.91 | |
United
| Facility | $3,066.00 | $6,648.00 | $13,893.00 |